| NPI | 1497715791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA md60187269) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD042891L) |
| 207R00000X Internal Medicine (Licence: WA MD60187269) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2016-07-14 |